NPI | 1053024554 |
---|---|
Entity Type | Organization |
Authorized Contact | LAURENCE BRADLEY Md/Owner 415-802-1310 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
207NS0135X Dermatology, Procedural Dermatology | |
Enumeration Date | 2022-12-29 |
Last Update Date | 2023-05-22 |